Effect of foot wedge applications on lower limb joints alignment in children with spastic diparetic cerebral palsy

Aydogmus I., BEK N., Yakut Y.

TURKISH JOURNAL OF PHYSIOTHERAPY REHABILITATION-TURK FIZYOTERAPI VE REHABILITASYON DERGISI, cilt.22, sa.1, ss.30-38, 2011 (ESCI, Scopus, TRDizin)

Özet

Purpose: This study was planned to investigate the initial effects of a 5 degrees wedge placed under the feet on lower extremity kinetic chain, under static conditions on spastic diplegic cerebral palsied children. Material and method: The subjects were 20 diplegic children between the ages 6 to 15 years (10.6 +/- 4.3). The inclusion criteria was determined as having lower extremity spasticity of maximum 3 according to Modified Ashworth Scale and being rated between levels I and III in GMFCS. Lateral and Posterior photographs of the subjects were taken under five conditions (without wedge, with valgus, varus, dorsi flexion and plantar flexion wedges) and lower extremity position was evaluated. For all conditions joint positions were measured and differences between the two lower extremities were investigated. Results: Statistical differences were found between the two lower extremities when ankle and hip joints were compared from the lateral side without wedges (p<0.05). While ankle joint angle differences between the extremities disappeared in all wedge conditions, hip joint differences disappeared only with plantar flexion wedge application. Hip joint and pelvis angles, in posterior side analysis, were bigger at without wedge conditions when compared with varus wedge conditions (p<0.05). Conclusion: It was concluded that different wedge applications do not cause a meaningful initial effect on the lower extremities of diplegic children, though; they may be effective in obtaining symmetry between the two lower extremities.